TREATMENTS
Non-surgical. For anyone who is active, especially athletes, non-surgical options are really not an
option. Non-surgical options are bracing and physical therapy. Bracing is just as it sounds. The
patient wears a knee brace to help with the instability of the knee. Sometimes they will also use
crutches during this time. Physical therapy is usually also prescribed once the swelling is under
control. Exercises to strengthen the leg muscles will assist in restoring function and stability to the
knee. But since most sports related injuries are more severe, surgery really is the only option.
Surgical. The ligament(s) have to be rebuilt. The “make up” of tendons do not allow them to do
well by just being stitched back together. To repair the ACL and restore knee stability, the ligament
must be reconstructed. The torn ligament must be replaced with a graft. The graft can come from
different areas of the body. Those areas are the patellar tendon, hamstring tendon, quadriceps
tendon or cadaver graft (yes, from a dead person). There are advantages and disadvantages for
any of the graft choices and a physician would discuss which option would be best.
SURGERY AND REHAB TIMELINE (general)
If the injury is just to the ACL, the surgery isn’t usually performed right
away. This allows time for the swelling to go down. Doing an ACL
reconstruction too early potentially increases the risk of scars forming in
the joint, which could cause a loss of knee motion. If the injury includes
other ligament damage or especially damage to blood vessels that affect
blood flow to the foot then surgery would be done sooner if not
immediate.
Rehab, surprisingly en ough, starts on the day of surgery. Patients are
given a set of exercises to start immediately in the recovery room. Seven
to ten days after surgery, most patients are stable enough to do away
with their crutches. Patients who have had other damage repaired at the
same time such as other ligaments and or meniscal repair it could take
several weeks.
The first couple weeks after surgery is getting the swelling down from surgery and working on the
range of motion for the knee. Plus the patient is educated on the rehab process…again. At the two
to six week mark, patients work on strengthening with light weights and resistance bands. Also the
use of use of treadmills, step machines and elliptical trainers. Full range of motion is worked on.
Six weeks to four months a progression in strength training for the knee and surrounding muscles.
Around three months jogging is introduced. From between four to six months the athlete can
possibly return to baseball. The variables in this return hinges on a few things. First, how much
reconstruction had to be done. The more things that needed to be fixed, the longer it will take to
return. Pain free full range of motion must be exhibited. No soft tissue complaints. Full strength
returned to the afflicted area (advanced strength exercises demonstrated). Also the ability to sense
the movement and position of muscles without visual guides. Lastly, the patient must meet all the
criteria to return to baseball. For most, anticipate six months before returning.
------------------------------------------------------------------------------------------------------------------------Reference:
*Courtesy: Teri McCambridge, M.D. & Gregory D. Myer, Ph.D., Matthew Panzarella, MD. Stopsportsinjuries.com
** Source: http://orthoinfo.aaos.org/